Provider Demographics
NPI:1609438126
Name:DEBORAH K. ROSEN, LPC LLC
Entity Type:Organization
Organization Name:DEBORAH K. ROSEN, LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:917-817-5940
Mailing Address - Street 1:300 CLARK AVE
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-4704
Mailing Address - Country:US
Mailing Address - Phone:475-441-0829
Mailing Address - Fax:
Practice Address - Street 1:357 WHITNEY AVE STE 201
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2364
Practice Address - Country:US
Practice Address - Phone:475-441-0829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-04
Last Update Date:2019-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty